In order to assess the ability of neoplastic trophoblasts to produce estrogen, dehydroepiandrosterone sulfate (DHAS) loading test was performed. Fifty mg of DHAS was administered intravenously to normal healthy subjects and patients with trophoblastic diseases. Serum concentrations of estradiol (E
2) were measured at 0, 15, 30, 60, 180 and 240 min after DHAS administration. E
2 conversion ratio (E
2CR) accumulated for 60 min after the injection was calculated.
In patients with hydatidiform mole, invasive mole, or choriocarcinoma, serum E
2 levels rapidly increased after the injection, reaching the peak at 30-60 min. E
2CR calculated in patients with these trophoblastic diseases was markedly higher as compared to that in normal healthy subjects. In the course of effective treatment, the E
2CR in those patients decreased to normal E
2CR levels in healthy subjects in a similar manner to declining pattern of serum hCG levels. There was a significant correlation between E
2CR and serum hCG level not only in patients with hydatidiform mole or invasive mole but also in patients with choriocarcinoma. When the correlationship between E
2CR and serum hCG levels in patients with choriocarcinoma was compared to that in patients with hydatidiform mole or invasive mole, the conversion rate of DHAS to E
2 in patients with choriocarcinoma was found to be smaller than that in patients with hydatidiform mole or invasive mole.
These results suggest that choriocarcinoma trophoblasts remain the enzyme activities of sulfatase, 3β-HSD and aromatase which are required for the conversion of DHAS to E
2 and that the capability of estrogen production in choriocarcinoma is lower than that in hydatidiform mole and invasive mole. Thus, it may be possible that analytical comparison of E
2CR to serum hCG levels in patients with trophoblastic diseases enables to speculate the character of neoplastic trophoblasts.
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